HomeMy WebLinkAbout2022 The Commonwealth of Massachusetts Fee
41.14444
Town of Yarmouth $60.00
Stables License
Number: BOHS-15-1250-07 Issue Date: 1/1/2022
Mailing Address: Location Address:
STEVEN B. JOHNSON 77 SHELBURNE RD
77 SHELBURNE ROAD WEST YARMOUTH. MA 02673
WEST YARMOUTH, MA 02673 •
IS HEREBY GRANTED A 2022 LICENSE
-
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2022 unless sooner suspended or revoked and is not
transferable.
Conditions
Allowed to have up to a total of 7 horses at above address.
PLEASE POST LICENSE ON PREMISES.
Board Hillard Boskey,M.D.,Chairman
Mary Craig, Vice Chairman
of Charles T.Holway,Clerk
Debra Bruinooge •
Health Eric Weston
Bruce G.Murphy,MPH,R.S., /James G.Gardiner 4.00)
Health Director/Assistant Health Director
TOWN OF YARMOUTH
Board of
... \, r ce Health
1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451
MATTACHEESE
' �'' Telephone(508)398-2231,ext. 1241 Health
Fax(508)760-3472 Division
APPLICATION FOR OPERATION-2022 HEALTH Ida: F'
STABLE
PLEASE COMPLETE ALL QUESTIONS E-MAIL
NAME .5 7-'2 v 0?-" /3, .,/of/.104- HOME TEL.NO. \S 0 b'� 9 S' 7f 7Z
STABLE ADDRESS 7 7 5I12L /3d/t-me, X. (in11 1A✓2S7 Yy1 /-041 SS
MAILING ADDRESS(IF DIFFERENT)
EMERGENCY CONTACT(NAME/PHONE#1 5'0 3 1
VETERINARIAN(NAME/PHONE#) 44 4,4,4,../At c� s-< P.t',yl 3-a ar
TOTAL NUMBER OF HORSES/PONIES 7 TOTAL NUMBER OF STALLS y / .v ,/U t,1 y'
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH HORSE/PONY/DONKEY/COW SEPARATELY:
ANIMAL NAME(IF APPLICABLE) / Wee,e ✓sHAyK
BREED View !tn O
YEAR ACQUIRED Za /7
COLOR y
SEX "d-Lh...a t C
DATE OF RABIES VACCINATION s-/,.,r t' -t
DATE OF EEE VACCINATION /
DATE OF OTHER VACCINATIONS H
TYPE OF STABLE/SHELTER w o0 A r cow G/t it 7-1, SIZE OF CORRAL AREA Tic lip i"' "ttS-szr fr/ram
(WOOD,CONCRETE,ETC.)
NUMBER OF HOSE BIB WATER OUTLETS a Z DRAINS WATER TROUGHS aw1Z t-4("a/-%tom
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 1 A G k Gt G d rn C 4 ti O n L Z e-49 3
TYPE OF FACILITY USED FOR MANURE STORAGE b P 2' )
METHOD OF MANURE DISPOSAL yAA, 604 //✓1 ( - 1//d/1 FREQUENCY Gc xit.ioi0 nit y
CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? 1///619) /j/ 2 r/L/ t
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO 1
(PLEASE NOTE: POULTRY, SWINE, SHEEP, CATTLE, GOATS REQUIRE SEPARATE LICENSURE.)
c RENEWAL
NEW APPLICATION- IF NEW APPLICATION,PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC.,AND ALL ENCLOSURES. ALSO,A
WRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes ) No
SIGNATURE DATE '� /Z�/ L� Z
FEES: STABLE& 1 H SE $30.00(+$5.00 each additional horse/animal) TOTAL DUE:$ ,o b
12/30/19